This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Acute Respiratory Failure (ARF) requiring mechanical ventilation affects 1.1 million of the 4.4 million people admitted to US Intensive Care Units (ICU) every year. Patients with ARF experience deconditioning, muscle weakness, joint contractures, dyspnea, depression, and reduced health-related quality of life, all of which may contribute to prolonged hospitalization and increased costs. Critical care rehabilitative therapy for patients with ARF is not uniform in its content. The proposed study will test the following standard therapy hypotheses: 1) shorten hospital stay in patients with ARF;2) will improve objective functional measures and quality of life at 6 months post-enrollment;3) will reduce biomarkers of inflammation;4) will decrease hospital costs. We will conduct a two-arm, randomized trial in 326 patients with ARF to compare Standardized Rehabilitation Therapy. Standardized Rehabilitation Therapy will consist of: passive range of motion, physical therapy and progressive resistance exercise. Our unique environment provides a hospital-funded, experienced Mobility Team (7days/week) consisting of a critical care nurse, physical therapist and nursing assistant to administer this protocol. The proposed study is a natural extension of our prior work. Multidisciplinary approach(Exercise Physiology, Physical Therapy, Nursing, Medicine, Basic Science, Health Economics)is supported by preliminary studies and is responsive to recent society consensus statements.